Courtney Jacobs, M.D.

Primary specialty

Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X

License

0101267326 Issued in VA

Practice address

864 S Clearview Pkwy
Apt 136
River Ridge, LA 70123-6323

Phone

(781) 696-2530

NPI assigned

Mar 22, 2016

Last updated

May 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric Medicine

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Childrens Specialty Group PLLCGroup PAC ID 5890788764, 89 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Childrens Specialty Group PLLC

  • Pediatrics Physician
  • Norfolk, VA
  • NPI 1255354130
  Medicare reassignment Care Compare group NPD
• Childrens Hospital of the Kings Daughters Inc

  dba CHKD Urgent Care

  • Urgent Care Clinic/Center
  • Chesapeake, VA
  • NPI 1578954590
  Medicare reassignment NPD
• Childrens Hospital of the Kings Daughters Inc

  • Clinical Social Worker
  • Norfolk, VA
  • NPI 1467641829
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1558723429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "864 S CLEARVIEW PKWY",
            "address_2": "APT 136",
            "city": "RIVER RIDGE",
            "state": "LA",
            "postal_code": "701236323",
            "telephone_number": "781-696-2530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "864 S CLEARVIEW PKWY",
            "address_2": "APT 136",
            "city": "RIVER RIDGE",
            "state": "LA",
            "postal_code": "701236323",
            "telephone_number": "781-696-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "COURTNEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101267326",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "VA",
            "license": "0101267326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter C Horowitz, MD
• Mary Hulin, MD
• Michael Paul Hulin, M.D.
• Phyllis Renee Jackson-Williams, DDS
• Anthony Jackson, DDS
• Marquita James
• Annie Jefferson
• Kelly Giardina Johnson, PHARMD
• Meghan Jones, MD, MPH
• Kelsey Amanda Joseph, SLP-A

• Pediatric Emergency Medicine (Pediatrics) Physician in River Ridge, LA
• Providers in River Ridge, LA by specialty
• Pediatric Emergency Medicine (Pediatrics) Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.